<div id="pad-wrapper" class="new-user">
	<div class="row-fluid header">
		<h3>添加推荐医院</h3>
	</div>
	<div class="row-fluid form-wrapper">
		<!-- left column -->
		<div class="span9 with-sidebar">
			<div class="container">
				<form class="new_user_form form-horizontal" action="/hospital/save" method="post" id="dataForm" enctype="multipart/form-data">
				<div class="field-box"></div>
				<div class="control-group form-group span12">
				  <label class="control-label" for="name">医院名称：</label>
				  <div class="controls col-lg-5">
					<input type="text" id="name" name="name"   placeholder="医院名称" value="" />
					</div>
				</div>
				<div class="control-group form-group span12">
					<label class="control-label" for="level">医院等级：</label>
					<div class="controls col-lg-5">
						<select class="search" name="level">
							<option value="1" >一等级</option>
							<option value="2" >二等级</option>
						</select>
					</div>
				</div>
				<div class="control-group form-group span12">
				  <label class="control-label" for="address">地址：</label>
				  <div class="controls col-lg-5">
					<input type="text" id="address" name="address" placeholder="地址"  value=""> </input>
				  </div>
				</div>
				<div class="span12 field-box"></div>
				<div class="control-group form-group span12 actions">
				  <label class="control-label"></label>
				  <div class="controls col-lg-5">
					  <button type="submit" id="btn-edit" class=" btn-flat primary">提交</button></li>
				  </div>
				</div>
				</form>
			</div>
		</div>
		<!-- side right column -->
		<div class="span3 form-sidebar pull-right">
		</div>
	</div>
	<script type="text/javascript">
		$(document).ready(function() {
			$('#dataForm').bootstrapValidator({
				message: 'This value is not valid',
				feedbackIcons: {
					valid: 'glyphicon glyphicon-ok',
					invalid: 'glyphicon glyphicon-remove',
					validating: 'glyphicon glyphicon-refresh'
				},
				fields: {
					name: {
						message: '医院名称不符合规则',
						validators: {
							notEmpty: {
								message: '医院名称是必填项，不能为空'
							}
						}
					},
					address: {
						message: '地址不符合规则',
						validators: {
							notEmpty: {
								message: '地址是必填项，不能为空'
							}
						}
					}
				}
			});

			/*
			$("#btn-edit").click(function(e){
				e.preventDefault();
				var name=$("#name").val();
				var address=$("#address").val();
				window.location.href="/hospital/save?name="+name+"&address="+address;
			});
			*/
		});
	</script>
</div>